1. Spit Tobacco Intervention for Athletes

Spit Tobacco Intervention for Athletes

Program Goals/Target Population

The Spit Tobacco Intervention for Athletes is an education program about the dangers of addiction and long-term use of using spit tobacco. It is targeted at young male athletes—especially those who play baseball—who use or are at risk of using spit tobacco.

Program Components

The intervention consists of two parts: a) a single-session, peer-led component and b) a dental component. The first component typically consists of a 50-minute, interactive meeting that includes a video tailored to baseball athletes, graphic slides of facial disfigurement associated with oral cancer and its surgical treatment, and a small group discussion of spit-tobacco advertisements aimed at young males. The dental component includes an oral exam from a dentist.

In addition, a behavioral counseling session helps participants establish a quit date. The brief counseling also explains nicotine addiction and suggests coping strategies for spit-tobacco cravings either to increase positive feelings or to decrease negative emotions and other withdrawal symptoms. Moreover, counseling points out that spit-tobacco use can be a highly automatic behavior intensely learned and practiced over time, so that the user can find himself using spit tobacco without deliberate realization or conscious desire. To address this automatic use of spit tobacco, counselors have athletes recall their use of spit tobacco in a typical day to identify reasons for use and to target dips used automatically for initial elimination in planning a schedule to taper down spit-tobacco use and gradually reduce nicotine exposure. Program participants also receive a follow-up call from a dental hygienist to discuss a quit date.

Program Theory

The intervention is grounded in cognitive social learning theory, which speaks to the importance of motivation to behavioral change. Behavioral change depends on an interest in making a change, having the skills to replace old behaviors with new ones, and a belief in one’s ability to perform the change.

Intervention ID

13 to 20


Study 1

Spit Tobacco Initiation

Walsh and colleagues (2003) found that the intervention appears to be ineffective in preventing the initiation of spit-tobacco use by nonusers. There was no significant difference between groups in the prevalence of spit-tobacco initiation.

Spit Tobacco Cessation

The intervention appeared to be effective in promoting spit-tobacco cessation. Prevalence of cessation was 27 percent in intervention high schools and 14 percent in control high schools. The intervention was most effective in promoting cessation among those who, at baseline, lacked confidence that they could quit, among freshman, and among nonsmokers.

Study 2

Spit Tobacco Initiation

Gansky and colleagues (2005) found that the intervention appeared to be more effective at preventing initiation than in promoting cessation. Intervention school athletes were less likely to initiate (5 percent) than control school athletes (8.4 percent).

Spit Tobacco Cessation

The intervention appeared to be ineffective in promoting spit-tobacco cessation. There was no significant difference in cessation rates between the two groups.

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